"If depression is creeping up and must be faced, learn something about the nature of the beast. You may escape without a mauling." – Dr. R.W. Shepherd

Newman University Men's Basketball Coach Mark Potter has a letter sitting on his desk. Every time he reads it, he is reminded that his past misery is serving a present purpose."Coach Potter, I am so thankful that you shared your story," the letter begins. "You saved my life. You allowed me to open up and talk to my parents and go get help so that I would no longer feel the way I've been feeling. I'm starting to go in the right direction."

The letter, written by a 17-year-old from Wichita, Kan., had been sent to the coach in response to Potter's decision to speak publicly about his battle with severe clinical depression. It was one of roughly 250 responses that Potter received to an article printed in his local paper, The Wichita Eagle.

But for Potter, it didn't matter if it was one or 1,000. "If I hadn't helped anybody else but this one young man, then what I went through was well worth it."Depression has been called an "elephant in the room" in the Christian church. The black sheep of all medical conditions. The one thing no one wants to acknowledge. Yet, it seems to be the one thing everyone is dealing with, either personally or through friends or family members. Everyone knows someone who is currently or has previously battled this disorder. And that's not just an assumption; it's a statistical fact.*

In the United States alone, 18.8 million people (close to 10 percent of the adult population) are affected by a depressive disorder in a given year. That's almost one out of 10 people.

Yes, you do know someone who battles depression, whether you realize it or not. And if you're a Christian, odds are that you don't. Odds are they're scared to tell you.

Fortunately, the tide is turning.

Mark Potter

A POTTER'S TALEIt was the beginning of a new season. The Newman University (Kan.) Jets were coming off a Sweet 16 appearance in the 2005 NAIA Tournament, and Coach Mark Potter was continuing to solidify his reputation as a quality basketball coach. He had a good team on the court and an even better one at home with a supportive Christian wife and two upstanding children. Life was sweet.

His wife, Nanette, was panicked at the sight of her husband. The typically outgoing, positive, upbeat Potter was being taken down in a mental battle.

"The normal worries that people have during a day were at a hundred times the level that they normally were," said Potter, now an NCAA Div. II coach after Newman's recent transition. "It was elevated to the point where all I could think was how I was going to survive that year and whether or not I was going to lose my job. I would be sitting in my chair at home and tears would be rolling down my face, and I wouldn't even know why."

He dealt with it alone as best he could, but inside Potter knew he was in a fight he couldn't win on his own. Unfortunately pride and embarrassment stood in the way of his desire to ask for help. He couldn't admit to himself — or to anyone else — that he couldn't handle life.

"The male ego sometimes really gets in the way of admitting the fact that there's a problem," Potter said. "In a lot of ways it was embarrassing, and I didn't want people to know what I was going through."

Then, there was also the faith side. As a Christian, Potter felt like he should be able to pray or read his way out of the funk. Surely the right Scripture would take away the fear. But nothing seemed to alleviate the constant anxiety and sadness, a fact that seemed only to add to the problem. Convinced that he didn't have enough faith to handle his situation, Potter constantly worried about his walk with the Lord.

Finally, Nanette stepped in and persuaded him to seek medical help, scheduling him an appointment with a local psychiatrist.

Potter was humiliated. But relief soon replaced his despair.

The psychiatrist quickly diagnosed the problem as severe clinical depression, a disorder in which the body produces low levels of certain hormones and neurotransmitters (often serotonin) that affect moods and mental patterns. The coach was prescribed medication in the form of selective serotonin reuptake inhibitors (SSRIs, or antidepressants) and forced to miss four weeks of coaching while he waited for the medicine to take effect.

After a month of limited activity at home, Potter began to regain the bounce in his step. He returned to his team, this time with a healthy perspective.

He realized that his own desire for control had put him in his position. He'd allowed his job to take the top priority in his life and hadn't entrusted it to the Lord. Thus, his anxiety had gained control of his mind and had manifested itself physically in depression.

"When you allow it to get to that level, and your brain starts to only concentrate on those things on a consistent basis, then you are sick," said Potter, who now shares his testimony of God's deliverance to FCA audiences in Kansas. "But it feels good to feel good again, and that's the best way to describe it."

Tommy Nelson

THE PASTOR'S STORYPastor Tommy Nelson can relate to Potter's depression battle scars. Though, for Nelson, a national speaker, respected author and the senior pastor of Denton (Texas) Bible Church, the onset of depression resulted from an overcrowded schedule.

For years, Nelson thrived on the impact God allowed him to have as a pastor. He taught his class of "Young Guns" from 6 to 7 a.m. four days a week, led three weekly men's studies, conducted a staff Bible study, and then led the country's largest singles' study on his days "off." On top of those studies were piled his normal pastoral duties that included four Sunday services. Then there were his extra book and study-guide developments. All accounted, it was not unusual for Nelson to teach anywhere from 13 to 20 times per week.

Finally, his schedule caught up with him.

It started nearly two years before his actual diagnosis. Nelson began to battle insomnia and unusual body aches. Doctors thought he might be developing allergies, but they could do nothing to cure it.

"You know how when you sleep on your arm and you wake up and it starts coming back to life? That's how my whole body would feel," Nelson said. "And then, I just fell into an emotional hole."

After his long battle with sleeplessness and aches, Nelson shut down emotionally. It wasn't necessarily sadness, just nothingness. A "pit," as he called it. He saw doctor after doctor, but no one could find anything physically wrong.

Finally, a member of his church suggested that he may be in a state of depression.

They were right. Nelson visited a psychiatrist, and in a matter of 30 minutes, the months of frustration and medical confusion were diagnosed.

"He listened to me for about 15 minutes and he said, 'You're garden variety. You're nothing problematic,'" said Nelson, who was relieved by the reassuring tone of his doctor. "His casualness made me feel better. He wasn't like, 'Good night! Call an ambulance!' No. He calmly went, 'You're no problem. I talk to you twice a day in different guys.'"

While the diagnosis was simple, the prescription went beyond medication. Nelson was forced to take four months completely off of work in order to allow his body to recover and was ordered to alter his lifestyle by cutting out many of the teaching opportunities he had grown to love.

"Now I'm just a regular old preacher," he laughed. "I had to cut back and start making my stuff real quality and strategic rather than running so hard and getting by on four or five hours of sleep."

He laughs now, but while in the storm, life was anything but roses for Nelson, who didn't sleep without the aid of medication for roughly a year. But his trials gave him ample ministry material and changed his perspective on life.

"There's a natural happiness to life when you're rightly related to it — just a joy — especially as a Christian; but when you are going through this, you can't feel it," Nelson said. "I think when you've finished going through something like that, you have a sensitivity to how you feel that you never had before. You don't take for granted just feeling good. It makes you very happy about the simple things like your mental health, because if something is wrong with your mind, it really scares you. So, whenever you get rid of it, you realize that the happiest thing in the world is just being you."

Ruth Graham

THE PREACHER'S DAUGHTERRuth Graham never felt any pressure from her parents to live up to the family name. The youngest daughter of Billy and Ruth Bell Graham, she more commanded herself to be perfect than was told to be so.

Thus, when she found herself the victim of her spouse's infidelity, she tried hard to pretend that everything was fine. Graham played the part of the "perfect Christian" who could overcome everything with a smile on her face. But inside she was crumbling.

"I thought it was honoring to God to just sort of cover it over and pretend that everything was all right," Graham said. "I tried to go on like nothing had happened, but obviously, something serious had happened. I was ashamed because I was having these negative emotions. I was humiliated. They were typical emotions, but I didn't know they were typical. I had no idea that what I was going through was normal."

Within six months, Graham began to realize that she was having trouble getting out of bed in the morning. Going to the grocery store was more than she could handle. She was exhausted by the idea of packing a suitcase to travel anywhere. She was simply overwhelmed by everyday life.

"My experience with depression was not sadness and weeping, but weariness," she said. "I just could not do normal things, and I began to withdraw from people and isolate."

Growing up under the impression that if a person sought counseling they were spiritually deficient, Graham eliminated seeking professional help from her list of options. She continued to struggle until, one day, she hit a breaking point.

"I was sitting in church, and the pastor, I'm sure, had preached a good sermon, but I'd had enough," she said. "I thought to myself, 'I can't take this anymore,' and I went home looking for razor blades."

She knew where she would do it. She knew how. She knew when. All she needed was the weapon of choice.

By God's grace, Graham could find no razor blades in the house, but the experience was an alarming wake-up call for the mother of three. Realizing her children were depending on her, she called a psychologist and made an appointment. Immediately she was comforted by the counsel.

"One of the greatest things he said to me was, 'You are not crazy,' because that's what I'd thought," Graham said. "It just felt so good to have that affirmation and support."

The counselor instructed Graham to see a medical doctor, and she was placed on anti-depressants. It took longer for her to find the proper medication for her body but, eventually, Graham was back on the right track.

With her experience, she now conducts "Get Real" conferences around the country. At these events, she and her team of experts talk about difficult issues — including depression, eating disorders and abortion — that Christians face, but that they are often afraid to address.

"Real life happens to Christians, and that's OK," she said. "God speaks into our real lives. People have to know that there is help. There is hope. We don't have to live in that dark tunnel. There is light, and we can come out of the darkness. And I'm very happy to encourage people who are suffering from depression that it's a physical problem."

DEPRESSION DEFINEDThese are just three examples of Christians who have battled and been delivered from depression. Maybe you or someone you love needs to be a fourth.

"The normal worries that people have during a day were at a hundred times the level that they normally were. ... All I could think was how I was going to survive that year."– Coach Mark Potter

It's time to talk about that elephant in the room.

First, let's address what depression is.

According to the National Institute of Mental Health, depression is a condition of the brain in which important neurotransmitters (chemicals that the brain cells use to communicate) are out of balance.

It's an incredibly scientific and complicated process, but the American Medical Association** explains it this way:

The certain neurotransmitters that communicate in the parts of the brain dealing with emotion — norepinepherine, serotonin and dopamine — are the ones commonly associated with depressive disorders. When a person endures a constant high level of stress, the body stops or reduces production of these neurotransmitters, and the brain is unable to send important signals dealing with emotion. This results in sadness, fatigue, insomnia, anxiety and a variety of other symptoms people with clinical depression experience.

That is where medication steps in. Common anti-depressants increase the brain's level of these neurotransmitters and help the brain communicate normally again. Generally, anti-depressants release the neurotransmitters immediately, while patients only begin to feel the positive effects several weeks after beginning treatment.

SHATTERED SILENCEEven with such a real, physical definition, depression is often viewed negatively within the church. Christians who suffer from the disorder are frequently labeled as spiritually weak and told to treat their illness with spiritual remedies.

Nelson, who has now become one of the nation's most sought-after voices on the topic, compares having a mental disorder in the church to having AIDS. "You're just not supposed to have it," he said.

He readily admits to being a depression naysayer before he personally faced the disorder, and jokes that he felt like Saul going to see the Witch of Endor when he first went to a psychiatrist. But after speaking with a professional and gaining an understanding of the physical side of depression, he realized that he had been wrong all along.

"Well-meaning Christians will moralize it and say that you are just going through some sort of sin," he said, drawing from his former mindset. "It's just like Job's friends in the Bible who said what he went through was because of something he'd done wrong. But if you read the story, you see that Job had to offer up a sacrifice for the sin of his friends, and that sin was their counsel — that only bad things happen to bad people."

Graham recalls being told to grab her Bible and go into the mountains for a week, and that, after doing so, she would be cured.

"I just began to cry and said, 'No! That won't work,'" she recalled. "Saying things like that puts the burden back on the person, and that's not fair. Because if you could physically see the blood and the guts and the wounds, you'd have them in intensive care. But because you can't see the physical part, you expect them to go on normally. But these people need intensive care. Loving, understanding care."

The issue of medicating depression is what causes the most debate. But Nelson counters the point, advising Christians not to be confused by the theology of Christian Science.

"We have to make sure we don't get caught up in saying that all diseases are in your head and that there should be no medicine," Nelson said. "God has given us medical science, and that's why we thank Him for vaccines."

Graham uses a medical illustration when making a similar point.

"If I had broken my leg, I would have gone to the doctor, and everybody would have been sympathetic," she said. "A person is not more spiritual if they don't go see a counselor. When you're under stress for a long period of time, the chemicals in your brain become unbalanced, and you need treatment. It's just as necessary to seek help as if you had broken a bone."

THE PROPER RESPONSERegardless of a person's stance on the use of anti-depressants, according to Graham, their proper response to those experiencing the disorder should never be one of judgment.

"God is the great healer. He made our minds. He made our bodies. He knows the chemicals in our bodies and has provided ways for us to get help."– Ruth Graham

"Jesus didn't condemn or criticize those who needed healing," she said. "He met them where they were, and He took them to the Father. That's what we need to do. We need to meet people where they are — in their mess, in their failures, in their sins — and take them the next step. But we can't do that if we're hammering away at them, judging and criticizing them."

Beyond the simple casting of judgment, Nelson said that believers must also be careful of making misconceptions about the Lord Himself.

"God is not karma. You'd better be careful about saying that you're going to have good things come out of good things and bad things out of bad things," he said. "Remember John 9:2-3 (KJV): '…who did sin, this man, or his parents, that he was born blind?... Neither hath this man sinned, nor his parents: but that the works of God should be made manifest in him.'"

That being said, Nelson warned that there are cases when sin can lead to depression. The intense stress that comes from a person's spiritual rebellion can trigger a chemical reaction in the brain and lead to the physical manifestation of depressive disorders.

Potter's lack of trust in the Lord regarding his career is a perfect example.

"I truly believe that if my priorities would have been in line, it wouldn't have gotten to the level it did," Potter said. "I believe this happened for two reasons: because the Lord wanted me to understand how to trust Him more and so I could help others who are going through it."

Caution to Coaches

One of the population groups at greatest risk for depression (and a big reason for our writing this article) is coaches — a people under constant pressure to start winning or be fired, or to keep winning or be fired.

"You can't ever rest as a coach," says Nelson, who played football at North Texas State and has sports ministry experience through FCA and through the coaches in his congregation. "It's dog-eat-dog. The only reason you wouldn't be under stress would be because you're winning, but then you have to keep winning. The higher you go, the greater the expectations. Every time you succeed, that success forms a link in your chain that you carry. It's not just that you've succeeded; you, now, for the rest of your life, have to maintain it."

In Potter's case, in order to keep coaching, he had to learn how to handle the pressure mentally. He had to learn that, if he put in the work, the Lord would take care of the results.

"I still have some of the same worries that I used to have, but there's a difference now," Potter said. "Now, I'm going to work my tail off and make sure that my team is prepared to the best of its ability. If I do that, then I'm doing my job. If we lose a game or continue to lose games, then I may lose my job. And maybe I need to at that point. But I can't worry about that and allow it to be at the forefront of my mind. There's no point in it."

BEYOND THE SYMPTOMSAs necessary as medication may be in some cases such as Potter's, it isn't the end of the story, nor is it the final cure for all forms of depression. It may treat the symptoms, but it will not treat the lifestyle.

Potter had to turn his desire for control over to the Lord. Nelson had to simplify his life. Graham had to acknowledge and deal with tragic circumstances.

"You've got to deal with the front end of whatever got you there," Nelson said. "You've got to find the stress point and what it was that produced such intensity. The medication won't cure that part. That will likely have to be a lifestyle change."

Added Potter: "I had to really get out of a complacent place in my faith. And there are some days I'm still complacent, but if I find myself allowing my thoughts to go back to where they were, I have to ask myself where my priorities are. Have I given everything up to the Lord, or am I still so worried about losing my job or losing basketball games that it affects me in a negative way? It's a daily choice to trust the Lord and know that He is in control."

ADVICE FOR THE FIREBut how does a person in depression take steps toward such a change? Where can they even begin?

Those are questions that Potter, Nelson and Graham are getting used to answering. What is their advice for those in the midst of the trial?

First, for those in depression themselves, their advice is a resounding charge to seek professional help. And that includes help in two forms: counseling to help work through the root issue of the depression and medical help to deal with what has manifested physically in the body.

"I love the verse in Deuteronomy that says, 'You have circled this mountain long enough. Now turn north,'" Graham said, referencing verse 2:3 (NASB). "There comes a point when you have to move forward and take steps to get out of the place where you are."

She encourages those in depression to establish a support group to confide in and to provide spiritual support. And above all else, to pray.

"God is the great Healer," she said. "He made our minds. He made our bodies. He knows the chemicals in our bodies and has provided ways for us to get help. We must continue to pray and lean on Him and trust Him to deliver us."

For those who have loved ones who may be experiencing depression, the trio suggests providing support, love and encouragement.

"Create a safe place," Graham said. "You be the one who understands. Don't tell them what to do. Don't give advice unless they ask for it. Just be there to love them and support them. And for pity's sake, don't tell them to get over it or to pull themselves up by their bootstraps. Don't just plaster a Bible verse over it and pretend it will go away, because it won't. Encourage them and love them."

Help is readily available in a variety of places, and Potter says even seeing a family physician is a positive move, though mental health professionals are the better bet.

"For those who don't want everybody to know they are struggling, that's OK," he said. "There's nothing wrong with that. Just taking a step to get help in any form is a step in the right direction."

Are You Depressed?

There is a difference between being sad and being clinically depressed. Symptom lists for clinical depression are available at a variety of Web sites. Try webmd.com or depression.about.com.

THE FINAL WORDWhether you are the one going through depression or if it is someone you love, never forget that God is our refuge and our strength. While professional help is often necessary, it will never replace the medicine that comes from the Word. It will merely supplement it.

"God can use many different avenues to heal people," Potter said. "In my case it was medication. Sometimes it won't be medication for people, but many times, in the case of depression, it will be the way to help them start feeling better and getting back on track. But God can do whatever He wants to heal people, and that's where faith comes in."

Wherever you are, whatever you need, don't lose hope. Understand that depression is one of the many hardships that Christ promised we would endure as Christians. If you are enduring this yourself, find Christ in the storm and trust Him to see you through. We have a High Priest who endured such mental anguish that He sweat blood the night before His crucifixion. Know that He understands and is with you always. And never forget the Word of encouragement from Proverbs 10:25 (NIV): "When the storm has swept by, the wicked are gone, but the righteous stand firm forever."

You will be OK. You will rise again. The storm will pass, and you will stand firm in the strength of the Lord. In the meantime, continue to seek the Lord, and know that it is OK to ask for help.

Information in this article is provided for information purposes only and is not a substitute for professional medical advice. For all health concerns, always consult a physician or health professional.

Where to Turn

If you or someone you love is experiencing symptoms of depression or anxiety, seek professional help immediately. Call a family physician, a Christian counselor or a local mental health facility. Also, check out some of the following online resources:

• For a comprehensive site regarding depression and a variety of other mental disorders, visit the official site of the National Institute of Mental Health.